GENERAL



121920-13779500APPLICATION FORADJUNCT FACULTY POSITIONPlease note that all gray text boxes will expand as information is typed into them.GENERAL 1. Name: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????Phone ( FORMTEXT ?????) FORMTEXT ?????PrefixFirstM.I.Last 2. Address: FORMTEXT ????? FORMTEXT ?????StreetApt. No. FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????CityStateZip Code 3. Email address: FORMTEXT ????? 4. Position sought: FORMTEXT ????? 5. How did you learn about the position at Roberts? FORMTEXT ????? 6. Present position and rank (if any): FORMTEXT ????? 7. With what religious tradition/denomination do you most closely affiliate? FORMTEXT ?????PREPARATION 1. Is a placement file or record of credentials available? FORMCHECKBOX Yes FORMCHECKBOX No If yes, please forward. Official college and graduate study transcripts must precede or be presented during an interview. 2. List in chronological order (beginning with the most recent) the educational institutions you have attended.Time PeriodInstitutionDegreeMajor of Study FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? 3. Identify other non-degree or post-graduate education pertinent to the position sought. FORMTEXT ????? 4. If pertinent, provide license or certification information. FORMTEXT ????? 5. Are you a veteran of the Armed Forces? FORMCHECKBOX Yes FORMCHECKBOX No If yes, what type of training or education did you receive while in the military? FORMTEXT ?????EXPERIENCE AND ADDITIONAL INFORMATION 1. List in chronological order (beginning with the most recent) all teaching, administrative, and/or professionally related positions held. Attach a separate sheet if additional space is needed. FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? EmployerAddressDates of Employment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? PositionName of SupervisorTelephone Number------------------------------------------------------------------------------------------------------------------------------- FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? EmployerAddressDates of Employment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? PositionName of SupervisorTelephone Number------------------------------------------------------------------------------------------------------------------------------- FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? EmployerAddressDates of Employment FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? PositionName of SupervisorTelephone Number 2. Identify any other pertinent employment or experience(s) you have had during the past ten years. FORMTEXT ????? 3. List memberships in professional societies. FORMTEXT ????? 4. Attach a list of articles you have published in educational or professional journals and/or books you have published. 5. List one each of the following reference types: 1) Former Employer, 2) Professional, and 3) Character Former Employer Reference: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????NameAddressPositionTelephoneProfessional Reference: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????NameAddressPositionTelephoneCharacter Reference: FORMTEXT ????? FORMTEXT ????? FORMTEXT ????? FORMTEXT ?????NameAddressPositionTelephone 6. Are you authorized to work in the United States? FORMCHECKBOX Yes FORMCHECKBOX No 7. Have you ever worked for Roberts Wesleyan College or Northeastern Seminary? FORMCHECKBOX Yes FORMCHECKBOX No 8. Have you ever left an employer involuntarily?* FORMCHECKBOX Yes FORMCHECKBOX NoIf yes, please explain FORMTEXT ?????9. Do you know of any reason why you cannot perform the essential functions of the job for which you are applying with or without a reasonable accommodation(s)?* FORMCHECKBOX Yes FORMCHECKBOX No If yes, please explain FORMTEXT ?????*An affirmative answer to this question(s) does not automatically preclude you from being considered for this position.PHILOSOPHY The Roberts Wesleyan College mission statement is:As a community of learners committed to historic Christianity, Roberts Wesleyan College seeks to prepare thoughtful, spiritually mature, service-oriented people who will help transform society.The mission focuses on three major goals:Scholarship: learning through discovery, interdisciplinary integration, application, and effective methods of teaching and learningSpiritual Formation:? nurturing people’s relationship with God through Christ through scripture, the historic Christian tradition, and experienceService: addressing the world’s needs through vocation, service learning, global perspectives, and social responsibility 10. In your teaching at Roberts Wesleyan College, how will you promote the mission of the College?? As part of this response, please describe your faith, your relationship with God, and your involvement with your church. FORMTEXT ?????I hereby authorize Roberts Wesleyan College to obtain information from my employer(s) and such other source(s) as the College determines to be reasonably necessary in connection with my pursuit of employment. I hereby release those sources from liability in connection with these inquiries. I hereby affirm that the information provided on this application (and accompanying documents) is true and complete to the best of my knowledge. I understand that falsified information or significant omission may disqualify me from further consideration in employment and/or constitutes a reason for dismissal.Signature FORMTEXT ?????Date FORMTEXT ?????RWC and NES comply with all applicable non-discrimination laws and are committed to the enhancement of human dignity and workplace diversity.How to submit this application: Please save this document to a computer file, and then submit via email to the designated contact person along with the other requested documents that can be submitted electronically.? Email addresses are noted on the position job posting on the internet. Additionally, your application must be printed, signed, and sent with other requested documents that cannot be submitted electronically to: Name of Department Chair/Program Director, Department/Program Name, Roberts Wesleyan College, 2301 Westside Drive, Rochester, NY 14624.ROBERTS WESLEYAN COLLEGEOffice of Academic Affairs2301 Westside DriveRochester, NY 14624-1997Telephone: 585.594.6944roberts.edu ................
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